C 反应蛋白与白蛋白比值与非 ST 段抬高型心肌梗死患者冠状动脉病变程度的关系。
Relationship between C-reactive protein-to-albumin ratio and the extent of coronary artery disease in patients with non-ST-elevated myocardial infarction.
机构信息
Cardiology Department, Haseki Training and Research Hospital, University of Health Sciences, Istanbul, Turkey.
出版信息
Coron Artery Dis. 2020 Mar;31(2):130-136. doi: 10.1097/MCA.0000000000000768.
BACKGROUND
This study aimed to investigate the predictive value of the newly defined C-reactive protein (CRP)-toalbumin ratio (CAR) in determining the extent and severity of coronary artery disease (CAD) in comparison with the other inflammatory markers such as neutrophil-tolymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), in patients with non-ST-elevated myocardial infarction (NSTEMI).
PATIENTS AND METHODS
This study is retrospectively designed and includes 205 patients with NSTEMI with a mean age of 56.6± 11.4 years. The study cohort was subdivided into two groups according to Synergy Between Percutaneous Coronary Intervention with Taxus and cardiac surgery score (SS) as low (<23) and intermediate-high (≥23). Complete blood counts, serum CRP, and serum albumin were obtained at admission. The CAR, NLR, and PLR values of all patients were calculated. Then, we evaluated the relationship of CAR, NLR, and PLR with the CAD extent and severity.
RESULTS
CAR and NLR were moderately correlated with SS (r = 0.517, P < 0.001; r = 0.222, P = 0.001, respectively), whereas PLR showed weak correlation with SS (r = 0.191, P = 0.006). According to multivariate analysis models, CAR, NLR, and left ventricular ejection fraction were found to be independent predictors of CAD severity (P < 0.05). The area under the curve (AUC) for CAR (AUC: 0.829; 95% confidence interval: 0.770-0.878) was significantly greater than the AUC of NLR (AUC: 0.657; 95% confidence interval: 0.588-0.722), with P value of 0.002. A CAR more than 17 predicted an intermediate-high SS with 86% sensitivity and 76% specificity.
CONCLUSION
Novel inflammatory marker CAR can be used as a reliable marker in prediction of CAD severity in patients with NSTEMI.
背景
本研究旨在探讨与中性粒细胞与淋巴细胞比值（NLR）和血小板与淋巴细胞比值（PLR）等其他炎症标志物相比，新定义的 C 反应蛋白（CRP）与白蛋白比值（CAR）在非 ST 段抬高型心肌梗死（NSTEMI）患者中预测冠状动脉疾病（CAD）程度和严重程度的价值。
方法
本研究为回顾性设计，纳入 205 例 NSTEMI 患者，平均年龄为 56.6±11.4 岁。根据 Synergy Between Percutaneous Coronary Intervention with Taxus and cardiac surgery 评分（SS）将研究队列分为低（<23）和中高（≥23）两组。入院时检测所有患者的全血细胞计数、血清 CRP 和血清白蛋白，并计算 CAR、NLR 和 PLR 值。然后，我们评估了 CAR、NLR 和 PLR 与 CAD 程度和严重程度的关系。
结果
CAR 和 NLR 与 SS 中度相关（r=0.517，P<0.001；r=0.222，P=0.001），而 PLR 与 SS 呈弱相关（r=0.191，P=0.006）。多元分析模型显示，CAR、NLR 和左心室射血分数是 CAD 严重程度的独立预测因子（P<0.05）。CAR 的曲线下面积（AUC）为 0.829（95%置信区间：0.770-0.878），显著大于 NLR 的 AUC（AUC：0.657；95%置信区间：0.588-0.722），P 值为 0.002。CAR 大于 17 预测 SS 为中高，敏感性为 86%，特异性为 76%。
结论
新型炎症标志物 CAR 可作为预测 NSTEMI 患者 CAD 严重程度的可靠标志物。
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